2017 This supercedes all previous order forms. (Shipping within the U.S.A. only). PLEASE MAIL THIS FORM WITH PAYMENT TO: Dancing Madrone Soap Co., P.O. Box 434, Willits, California 95490 MAKE CHECKS PAYABLE TO: Dancing Madrone Soap Co.(Payment in USD) Name __________________________________________________________________ Address_________________________________________________________________ (City, State, Zipcode ) Contact Info _____________________________________________________________ (email & or telephone)______________________________________________________ MINIMUM ORDER: 3 ITEMS

CHOICE OF PRODUCTS Use back of form for additional items.
1. _______________________________________
2. _______________________________________PRICE INCLUDES SALES TAX (Calif.)
3. _______________________________________REG. SOAP-$4.00 PER BAR
4._______________________________________ FACIAL SOAPS-$6.00/BAR
5. _______________________________________PEPPERMINT FOOT BUTTER - $4.00/TIN
6. _______________________________________SOLID LOTION BAR - $4.00/TIN
7. _______________________________________
8._______________________________________
9. ______________________________________ CALCULATE YOUR ORDER TOTAL
10. ____________________________________Product Total_____________._____
11.______________________________________
12.____________________________________Shipping Total_____________._____
13.______________________________________ TOTAL DUE___________._____
_

CALCULATING THE SHIPPING RATE: New rates effective 1/22/17
Flat rate priority mail boxes used for shipping.
1. 3 to 6 items $7.15
2. 7 to 36 items $13.60
3. 37 to 72 items $18.85